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NPI Code Detail

MEDICARE: PAUL JAN MELICHAR M.D.

MEDICARE:   PAUL JAN MELICHAR  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician18.458MN

General Provider Information

NPI Number : 1023376209
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL JAN MELICHAR M.D.
Provider Business Mailing Address
First Line : 5512 BROOK DRIVE
Second Line :
City : EDINA
State : MN
Zip : 55439-1349
Country : US
Telephone Number : 952-941-3136
Fax Number :
Provider Business Practice Location Address
First Line : 5512 BROOK DRIVE
Second Line :
City : EDINA
State : MN
Zip : 55439-1349
Country : US
Telephone Number : 952-941-3136
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2012
Last Update Date : 04/25/2012

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Directions to “ PAUL JAN MELICHAR M.D.” Practice Location

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